Coronavirus (COVID-19) Lab Testing

Virginia Premier will cover the full cost, waiving any co-pays or cost sharing for coronavirus (COVID-19) diagnostic testing. 

Criteria for Testing:

Testing for the coronavirus (COVID-19) requires a Provider requisition and the specimen must be collected in a physician office, clinic or hospital to be valid.

Laboratories and Requirements:

Providers should confirm whether hospitals have the technology to render a coronavirus (COVID-19) test.  Here are laboratories that can conduct the test as needed:

Billing and Claims for Testing Services:

Health Plan
Prior Authorization Required?
COVID-19 HCPCS Code
Coverage
Effective Dates
Medicaid/ Medicare/ Individual and Family
No
U0001 For SARS-CoV-2 (CDC testing laboratories)
Yes
On or after March 12
Medicaid/ Medicare/ Individual and Family
No
U0002 for SARS-Cov (non-CDC laboratories)
Yes
On or after March 12
Medicare Advantage/ Individual and Family
No
U0003, SARS-CoV-2 (high throughput technologies)
Yes
On April 14, 2020
Medicare Advantage/ Individual and Family
No
U0004, SARS-CoV-2 (high throughput technologies)
Yes
On April 14, 2020
Medicare Advantage/ Individual and Family
No
G2023, SARS-CoV-2 (specimen collection)
Yes
On March 1, 2020
Medicare Advantage/ Individual and Family
No
G2024, SARS-CoV-2 (specimen collection, SNF/Home Health)
Yes
On March 1, 2020
Medicare Advantage/ Individual and Family
No
86318, (antibody, qualitative or semiquantitative, single step)
Yes
On April 10, 2020
Medicare Advantage/ Individual and Family
No
86328, SARS-CoV-2 (antibody testing, single step)
Yes
On April 10, 2020
Medicare Advantage/ Individual and Family
Yes
86769, SARS-CoV-2 (antibody testing, multi-step)
Yes
On August 10, 2020
Medicare Advantage/ Individual and Family
Yes
87635, SARS-CoV-2 (amplified probe technique)
Yes
On August 10, 2020

Resources

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